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NPI Code Detail

MEDICARE: KRISTY HAWLEY BCBA LABA

MEDICARE: KRISTY HAWLEY BCBA LABA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health Counselor
2103K00000XBehavior Analyst

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
11303287OTHERMAMBHP
299618201OTHERMANETWORK HEALTH
3042611055OTHERMATAX ID
41004745OTHERMANHP
5M18633OTHERMABCBS
60000023532OTHERMABMC
71004745OTHERMAFALLON

General Provider Information

NPI Number : 1568902971
Entity Type Code : Individual
Provider Name (Legal Business Name) : KRISTY HAWLEY BCBA LABA
Provider Business Mailing Address
First Line : 100 N PACIFIC COAST HWY STE 1400
Second Line :
City : EL SEGUNDO
State : CA
Zip : 90245-5602
Country : US
Telephone Number : 310-856-0800
Fax Number :
Provider Business Practice Location Address
First Line : 278 MILL RD
Second Line :
City : CHELMSFORD
State : MA
Zip : 01824-4106
Country : US
Telephone Number : 617-812-9454
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/03/2017
Last Update Date : 11/19/2024

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Directions to “ KRISTY HAWLEY BCBA LABA” Practice Location

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